MEDICARE: GLOBAL REHABILITATION CLINIC, SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor
2	208100000X	Physical Medicine & Rehabilitation Physician
3	208VP0014X	Interventional Pain Medicine Physician
4	213E00000X	Podiatrist
5	225100000X	Physical Therapist
6	363LF0000X	Family Nurse Practitioner
7	261Q00000X	Clinic/Center	042617906	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	210033	OTHER	IL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	01632135	OTHER	IL	BCBS GROUP NUMBER

General Provider Information

NPI Number	:	1023101060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL REHABILITATION CLINIC, SC

Provider Business Mailing Address
First Line	:	8565 W DEMPSTER ST
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-1401
Country	:	US
Telephone Number	:	847-299-7000
Fax Number	:	847-299-7007

Provider Business Practice Location Address
First Line	:	8565 W DEMPSTER ST
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-1401
Country	:	US
Telephone Number	:	847-299-7000
Fax Number	:	847-299-7007

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PETER SLAVIN
Credential	:	DC
Telephone Number	:	847-299-7000

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/04/2025

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